What causes elevated liver enzymes and white blood cells

Your liver is truly a powerhouse of an organ. It helps your body fight disease and infection, removes toxins, creates energy from the foods you eat, and so much more. Behind the scenes, helping the liver perform all of these critical functions are enzymes. These chemicals enable and accelerate the chemical reactions that your liver carries out as it works to keep your body healthy. When these enzyme levels become elevated, however, it means that damage has occurred in your liver. Left unchecked, this can lead to serious — and even fatal — consequences.

Causes of High Liver Enzymes

Elevated liver enzymes is a sign that something has caused damage or inflammation to occur within your liver. The most common causes of high liver enzyme levels are:

• Fatty liver disease
• Hepatitis
• Drug or alcohol abuse
• Certain prescription and over-the-counter medications
• Metabolic syndrome
• Cirrhosis

While some of the causes of elevated liver enzymes can be chronic, severe liver conditions, that’s not always the case. Many times levels are only temporarily elevated and will return to healthy levels once the underlying cause is treated.

Symptoms of Elevated Liver Enzymes

High liver enzyme levels don’t immediately cause any signs or symptoms to develop, but the underlying condition often will. Common symptoms of liver disease include:

• Jaundice – yellowing of the skin and whites of eyes
• Dark urine
• Abdominal swelling/pain
• Fatigue
• Low appetite
• Joint pain
• Muscle soreness
• Itchy skin

Risk Factors for Elevated Liver Enzymes

The risk factors for elevated liver enzymes are really risk factors for liver disease. While some liver conditions may be hereditary or environmental, many are brought on by lifestyle habits. The food and chemicals you put into your body all have an effect on your liver, and can lead to varying levels of liver damage and deterioration. Some of the most common risk factors include:

• Excessive alcohol use – more than two drinks a day for men, or one for women, according to CDC guidelines
• Overweight / Obesity – generally defined as having a BMI of over 25 for adults
• Family history of liver disease
• Have prediabetes or diabetes

Diagnosis & Treatment for High Liver Enzymes

Elevated liver enzymes are detected through regular blood tests. These tests usually check for elevated levels of:

• Alanine transaminase (ALT)
• Aspartate transaminase (AST)
• Alkaline phosphatase (ALP)
• Gamma-glutamyl transpeptidase (GGT)

If your healthcare provider determines that you have elevated liver enzymes, they will probably want to run other tests to get to the root of the underlying issue. Only once that is determined can an effective treatment plan be created.

High Liver Enzymes Treatment

Lowering high liver enzyme levels will depend on the underlying cause, but in most cases these levels can be brought back within healthy limits and are not indicative of a chronic, severe liver condition. Some possible treatment options include:

• Healthy diet and exercise – this not only will help prevent or reduce overweight/obesity, it will boost your overall health, including that of your internal organs
• Reducing or avoiding drug/alcohol intake – since these substances can be especially harmful to your liver, keeping consumption levels to healthy limits (or avoiding them altogether) will certainly improve your liver health
• Adjusting medications – some prescription and over-the-counter medicines can cause inflammation of the liver. If your medication regimen is causing liver inflammation or damage, your doctor will work with you to create a safer treatment plan
• Manage blood sugar – this is especially important for diabetics and those suffering from metabolic syndrome. Keeping blood sugar within healthy levels can prevent the underlying conditions from causing additional liver damage

If You Need Blood Screenings or Help Managing Elevated Liver Enzymes, Nurse Practitioners of Florida Can Help

At Nurse Practitioners of Florida, we have a dedicated team of certified nurse practitioners who have an unwavering commitment to providing you with care and compassion. When you call any of our locations, you will be greeted by a live person who’s ready to offer acute medical care as well as preventive measures — including flu vaccines. And, above everything else, you will be treated like family.

If you need assistance, call us or fill out our online contact form.

Liver enzymes are protein structures that carry out various chemical reactions within the liver. The liver itself is responsible for several functions, including primarily detoxifying various metabolites, synthesizing proteins, and producing digestive enzymes.

The liver enzymes also have a significant role in metabolism, regulating red blood cells (RBCs), and glucose synthesis and storage. They also control the levels of chemicals in the blood and help excretes waste products. Another function of liver enzymes is producing bile and substances that help your blood clot, break down food and toxins, and fight infection. Thus, a high liver enzyme level can be harmful to one's health.

These liver enzymes are alkaline phosphatase (ALP), alanine transaminase (ALT), aspartate transaminase (AST), and gamma-glutamyl transferase (GGT). If your liver is inflamed or damaged, it releases the liver enzymes into your bloodstream (usually ALT or AST). This causes an increase in liver enzymes in the blood.

Causes of Elevated Liver Enzymes

An increase in liver enzymes can be attributed to liver inflammation and damage, which have many causes.

The most commonly diagnosed cause of elevated liver enzymes and liver inflammation is a fatty liver disease (FLD). FLD is a common condition caused by the storage of extra fat in the liver. According to research, almost half of patients with high liver enzyme levels have fatty liver disease.

Other causes for a high level of liver enzymes can include:

• Metabolic disorders such as heart disease, stroke, and diabetes
• Hepatitis A, B, or C
• Alcohol or substance abuse
• Cirrhosis (permanent scarring of liver tissue)
• Autoimmune diseases such as type-1 diabetes and hepatitis
• Celiac disease
• Liver cancer
• Mononucleosis
• Blood poisoning is also known as sepsis
• Wilson's disease
• Inflammation of the muscles or polymyositis
• Some types of medications, including certain kinds of pain relievers and statins

Can Stress Cause Elevated Liver Enzymes?

Stress and anxiety are proven to contribute to high liver enzyme levels since they can reduce blood flow to the liver. Stress is also connected to high cortisol levels, which, in turn, is connected to liver damage. Additionally, NKT (Natural Killer Cells) expand in the liver during periods of stress and kill liver cells, making liver conditions worse.

Other connections of liver disease and stress are:

• People with hepatitis C often comment that a period of stress usually leads to a 'flare-up' of symptoms, especially fatigue.
• In patients with the persistent condition of Hepatitis B, there is a relationship between depression and ALT (alanine aminotransferase) levels that indicate whether you have liver disease or injury.
• Liver transplant patients suffering from depression, anxiety, and stress-triggered mood swings are more likely to reject the transplanted liver.

How To Know If You Have Elevated Liver Enzymes

Most people with elevated liver enzymes are usually asymptomatic, but the underlying conditions responsible for the high levels of liver enzymes may show themselves in the form of symptoms. Liver damage and other diseases that may be a probable cause show symptoms such as:

• Abdominal pain or cramps
• Dark urine
• Fatigue
• Itching
• Jaundice (yellowing of your skin or eyes)
• Light-colored stools
• Loss of appetite
• Nausea
• Vomiting

Tests For Elevated Liver Enzymes

If you have symptoms of conditions that typically cause liver damage, your doctor will usually order a test for elevated liver enzymes.

Routine blood tests can usually detect a high level of liver enzymes in the blood. This test detects increased levels of AST and ALT, which are enzymes that an inflamed liver releases. Different ratios of AST to ALT may indicate the various underlying causes. If you have increased levels of  AST or ALT, your doctor will conduct further diagnostic testing to determine the underlying condition.

Your healthcare provider may perform a liver function test (LFT) or liver panel to screen for this specific concern to check your liver enzyme levels. A liver function test is a series of tests that evaluate the levels of certain enzymes and other proteins in your blood. Your provider may prescribe regular liver function tests for you if you are at risk or have symptoms of liver damage.

Treatment Options

For most patients with a high level of liver enzymes, the level usually returns to normal after 2 to 4 weeks following the doctor's recommended treatment plan. However, if this is not the case, your doctor may order more blood tests or imaging tests and refer you to a hepatologist specializing in liver diseases.

The treatment for elevated liver enzymes will focus on managing the underlying condition causing the increased levels. Since the underlying cause of liver damage is usually responsive to treatment.

Treatments for the common causes may include:

• Weight loss
• Reduction in alcohol consumption
• Eating a healthful, balanced diet
• Managing blood sugar and stress levels
• Increasing intake of fluids
• Antiviral medication in cases of hepatitis

Cirrhosis, however, is not a curable condition, although treatments such as a modified diet, weight loss, and reduced alcohol consumption can reduce the risk of further liver damage. The prompt diagnosis and treatment of conditions that affect the liver can help prevent cirrhosis.

Diagnosis Heaading

Quick brown fox jumps over the lazy dog.

Antinuclear Antibody (ANA)

Antinuclear Antibody (ANA)

Antinuclear Antibody (ANA)

Antinuclear Antibody (ANA)

Symptoms Heaading

Feeling weakness when quick brown fox jumps over the lazy dog. Again when quick brown fox jumps over the lazy dog. This time will pass.Feeling weakness when quick brown fox jumps over the lazy dog. Again when quick brown fox jumps over the lazy dog. This time will pass.Feeling weakness when quick brown fox jumps over the lazy dog. Again when quick brown fox jumps over the lazy dog. This time will pass.Feeling weakness when quick brown fox jumps over the lazy dog. Again when quick brown fox jumps over the lazy dog. This time will pass.

Antinuclear Antibody (ANA)

Antinuclear Antibody (ANA)

Antinuclear Antibody (ANA)

Antinuclear Antibody (ANA)

Diagnosis Heaading

Recommended Tests

Alkaline Phosphatase

An alkaline phosphatase (ALP) test measures the amount of this enzyme in the blood. It is raised in certain kidney, intestinal and bone disorders.

Aspartate Aminotransferase AST

(AST) test measures the amount of this liver enzyme in the blood. AST levels can test for liver damage

Gamma-glutamyl transferase GGT

Gamma-glutamyl transferase (GGT) levels can be abnormally high in patients with liver or bone disease. In conjunction with some other blood tests, GGT levels can be used to determine the cause of liver or bone diseases.

Liver Function Test LFT

Liver function test (LFT) are a group of blood tests that measure liver function and liver injury. Abnormal LFTs are most commonly a result of liver inflammation. Certain viral infections and drugs causing hepatitis can also cause abnormality of these tests.

Alanine Aminotransferase ALT

An Alanine Aminotransferase (ALT) test measures the amount of this enzyme in the blood. ... ALT was formerly called serum glutamic pyruvic transaminase (SGPT). ALT is measured to see if the liver is damaged or diseased. Low levels of ALT are normally found in the blood

CT Abdomen with Contrast

Computed tomography (CT) of the abdomen is a diagnostic imaging test used to help detect diseases of the small bowel, large bowel and other internal organs, and is often used to determine the cause of unexplained abdominal pain. Please talk to your physician regarding ordering and more details about this test.

CT Abdomen without Contrast

Computed tomography (CT) of the abdomen is a diagnostic imaging test used to help detect diseases of the small bowel, large bowel and other internal organs, and is often used to determine the cause of unexplained abdominal pain. Please talk to your physician regarding ordering and more details about this test.

Ultrasound Abdomen

This ultrasound is commonly used to image the structures in your abdomen and pelvis including liver, spleen, kidney, urinary bladder and gallbladder etc. Please talk to your physician regarding ordering and more details about this test.

Ultrasound Liver And Gallbladder

This ultrasound is commonly used to image your liver and gallbladder to look for causes of hepatitis, abdominal pain etc. Please talk to your physician regarding ordering and more details about this test.

Acute Hepatitis Panel with confirmation

Hepatitis is an inflammation and enlargement of the liver. One of the most common causes of acute hepatitis is infection with a hepatitis virus, usually hepatitis A, hepatitis B or hepatitis C. An acute viral hepatitis panel is a group of blood tests often performed together to help diagnose viral hepatitis.

HEPATITIS PANEL

This test detects common hepatitis viruses in patients diagnosed with inflamed liver (hepatitis).

Liver Kidney Mircosomal LKM-1 Antibody-IgG

Liver Kidney Microsomal Type 1 Antibodies help diagnose autoimmune hepatitis and distinguish it from other causes of liver injury

Ultrasound Abdomen Complete

Alkaline Phosphatase Isoenzymes

Alkaline Phosphatase Isoenzymes - When the Total Alkaline Phosphatase activity is increased, the Isoenzymes are useful in determining the source of the increased activity.

Liver Panel

Components: Albumin, Alk Phos, ALT, AST, Cholesterol, GGTP, Total Protein, Bilirubin, Total, Bilirubin, Direct, LD

Soluble Liver Antigen (SLA) IgG Antibody

Anti-soluble liver antigen antibodies are detected in 10-30% of patients with type 1 autoimmune hepatitis (AIH), but not in patients with type 2 AIH, primary sclerosing cholangitis or primary biliary cirrhosis. The antibody is directed against a UGA suppressor tRNA-associated protein.

Liver Cytosol (LC-1) Autoantibodies

Liver cytosol autoantibodies (LC-1) can be detected in patients with autoimmune hepatitis type 2 in the presence or absence of Liver-Kidney Microsome (LKM) autoantibodies. LC-1 are typically not associated with autoimmune hepatitis type 1, primary biliary cirrhosis or drug-induced hepatitis.

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Farah Jassawalla

Farah Jassawalla is a graduate of the Lahore School of Economics. She is also a writer, and a healthcare enthusiast, having closely observed case studies while working with Lahore's thriving general physicians at their clinics.

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